Breast Cancer and the 5-Year Survival Rate Myth

August 25, 2019

“Breast Cancer and the
5-Year Survival Rate Myth” While running for president
of the United States, former New York
Mayor Rudy Giuliani ran a campaign ad
contrasting his chance of surviving prostate
cancer in the US—82%— with the same chance of surviving
prostate cancer in England, only 44% under socialized medicine, where they don’t do routine
PSA testing for prostate cancer. To Giuliani, this meant
that he was lucky to be living in New York
rather than old York, because his chances of
surviving prostate cancer seemed to be twice as
high here in the U.S. Yet, despite this
impressive difference in this five-year survival rate,
the mortality rate— the rate at which men were
dying of prostate cancer— was about the same in
the U.S. and the U.K. Wait, what? PSA testing increased survival
from 44 to 82% – how is that not evidence that screening saves lives? For two reasons: lead time bias and
over-diagnosis bias. I’ve talked about over-diagnosis, where a cancer is picked up
that would have otherwise never caused a problem. Without screening, let’s say
out of a thousand people with progressive cancer, only 400 are alive 5 years later; so, without screening 5-year
survival – only 40%. But, let’s say with screening, an additional 2000 cancers
are over-diagnosed, meaning you picked up cancers
that would have never caused a problem or even would have
disappeared on their own. Since the cancer was harmless, five years later, of course,
they’re all still alive, assuming their unnecessary
cancer treatment didn’t kill them, and, all of a sudden,
you just doubled the 5-year survival rate even though in either case,
the same number of people died from cancer. That’s one way how
changes in survival rates with screening may not correlate with changes in actual
cancer death rates. The other is lead time bias. This is how it works. Imagine a group of patients
in whom cancer was diagnosed because of symptoms
at age 67 years, all of whom die at age 70. Each patient survives
only 3 years; so, 5-year survival
for this group is 0%. Now, imagine that same group undergoes screening. Screening tests by definition
lead to earlier diagnosis. Suppose that with screening, cancer is diagnosed in all
patients at age 60 years, but imagine in this case they, nevertheless, all still
die at age 70 years. In this scenario, each
patient survives 10 years; so, the 5-year survival
for this group is 100%. Survival just went
from zero to 100%. Call the newspapers! With this new screening test, now cancer patients are
living 3 times longer — 10 years instead of 3—
it’s a miracle! Whereas all that really
happened in this case was that the person was
treated as a cancer patient for an additional 7 years, which, if anything, probably just diminished their
quality of life. So, that’s the second way
how changes in survival rates with screening may
not correlate with changes in actual
cancer death rates. And, in fact, the
correlation is zero. There is no correlation at all between increases
in survival rates and decreases in
mortality rates. That’s why “if there
were an Oscar for misleading statistics,
using survival statistics to judge the benefit
of screening would win a lifetime
achievement award hands down.” There is no way to disentangle
the lead time bias and the over-diagnosis bias
from screening survival data. That’s why these statistics
are meaningless when it comes to screening. Yet, that’s what you
see in the ads and the leaflets from most
of the cancer charities. That’s what you hear
coming from the government. Even prestigious cancer centers, like M.D. Anderson, have tried to hoodwink the
public like that. If you’ve never heard
of lead time bias, don’t worry –
you’re not alone. Your doctor may not have either. Fifty-four of 65 physicians
surveyed said they did not know what lead-time bias was. And then, when they asked
the remaining 11, “OK, what is it?”,
only 2 were actually correct. So, at this point
in the video, already, you may know more about this than 97% of doctors. To be fair, though, maybe they
don’t recognize the term, but understand the concept? Nope… “The majority of primary
care physicians did not know which screening statistics
provide reliable evidence on whether screening works.” They were 3 times
more likely to say they would “definitely recommend”
a cancer screening test based on irrelevant evidence, compared to a test that
actually decreased cancer mortality by 20%. If physicians don’t even
understand key cancer statistics, how are they going to effectively
counsel their patients? “Statistically illiterate physicians are doomed to rely on their
statistically illiterate conclusions”, or on local customs, or on industry
representatives and their information.

How about early detection and replacing chemo with diet and exercise? Maybe the scare of cancer can change people's lifestyle to make them serious about their health. Also, are these stats you used in this video up to date with the latest cancer treatments?

So in a other word, more people dies from cancer treatments. The treatments will only make them think they will prolong their life but in reality, if they wouldn’t not known in the first place, they would have live a better life without treatments.

I have never gotten a mammogram because of what you explained here. I already knew all this but not in the terms you used. I've watched cancer diagnosis and cancer deaths explode since I graduated from high school in 1980. I've noted all the charity events funneling money into the hands of those SUPPOSEDLY finding a cure but cutting out, radiating and chemo are STILL the norm for treatment. WHY!?!?! And where is the accountability? Where is the report on where we are in new treatments? We're giving them multi million dollars in charity donations for that cure and all we get is cut, radiated and poisoned to death in return. Stop feeding the monster and cancer will all but disappear.

Thanks Dr. Gregor for this video and another one you did about overdiagnos breast cancer. I went vegan almost a year ago and I'm glad I did but these studies about cancer really opens a person's eyes to what you die from the actual cancer or the treatment that virtually destroys a person's immune system.

Please Dr. Greger reply to my question:My nephew is 15 and has type.1 diabetes. My question is… theoretically if he stops consuming milk protein for ever. the autoimmune reaction which kills beta cells will never occur again? since he is only 15 he can still grow some beta cells and theoretically not inject any insulin in the future?

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So this is why they constantly hammer home early detection is KEY to survival. No, it's key to their stats being able to be misrepresented on the 5 year survival rates. So it's all about money in not survival. Cancer is a total scam.